This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. ABSTRACT The use of glucagon suppressors pramlintide and exenatide is well established in adult patients with T2DM, but there is a lack of information regarding an effective glucose lowering effect in pediatric T2DM. Previous studies from our laboratory showed that there is unabated early postprandial hyperglucagonemia in children with T2DM contributing to the marked postprandial hyperglycemia. There is insulin, amylin and GLP-1 deficiency in children with T2DM requiring insulin therapy. Both amylin and GLP-1 are potent endogenous glucagon suppressors. The glucose and glucagon lowering effect of the amylin analog pramlintide and the GLP-1 receptor agonist exenatide will be tested in insulin requiring children with T2DM. The lowest adult recommended doses would be used. With an increasing incidence of T2DM in the pediatric population, it is incumbent upon us to research new therapies in an effort to improve glycemic control and prevent the long-term micro and macrovascular complications associated with diabetes.